Nitroprusside inhibition of platelet function is transient and reversible by catecholamine priming.
Nitroprusside inhibition of platelet function is transient and reversible by catecholamine priming.
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硝普钠对血小板功能的抑制是短暂的，并且可通过儿茶酚胺引发而逆转。
DOI：
10.1097/00000542-199512000-00003
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发表时间：
1995
期刊：
影响因子：
8.8
通讯作者：
Hines,R
中科院分区：
文献类型：
--
作者：
Harris,SN;Rinder,CS;Rinder,HM;Tracey,JB;Smith,BR;Hines,R
背景硝普钠体内抑制血小板功能的时程和可逆性尚不清楚。方法在人类志愿者服用硝普钠（18 mg）之前和之后以及在体外研究中，分别检查血小板聚集和 P-选择素表达，作为血小板致密和 α 颗粒释放的指标。静脉注射晶体和/或去氧肾上腺素治疗硝普钠引起的低血压。结果与输注前研究相比，停止硝普钠输注后立即和4分钟血小板聚集至肾上腺素显着受到抑制，但在停止硝普钠输注后8和12分钟恢复到基线。然而，即使在硝普钠输注最大时，体内硝普钠后对二磷酸腺苷的致密释放和α颗粒释放也从未受到显着抑制。与我们的体内研究结果相反，富含血小板的血浆与硝普钠的体外孵育导致对二磷酸腺苷的致密和α颗粒释放的显着抑制。硝普钠的这些体外抑制作用可以通过用肾上腺素而不是去氧肾上腺素预处理来逆转。结论在正常志愿者中，硝普钠抑制血小板聚集到肾上腺素，但不抑制二磷酸腺苷；停用硝普钠后8-12分钟内抑制作用被逆转。肾上腺素预处理可逆转硝普钠对二磷酸腺苷的体外血小板功能抑制作用。由于其抗血小板作用的快速可逆性，即使存在凝血功能受损的可能性，硝普钠也可能在临床上有用。
BackgroundThe time course and reversibility of sodium nitroprusside's in vivo inhibition of platelet function are unclear.MethodsPlatelet aggregation and P-selectin expression as measures of platelet dense and alpha-granule release, respectively, were examined before and after administration of sodium nitroprusside (18 mg) to human volunteers and in in vitro studies. Hypotension occurring with sodium nitroprusside administration was treated with intravenous crystalloid and/or phenylephrine.ResultsCompared with preinfusion studies, platelet aggregation to epinephrine was significantly inhibited immediately and 4 min after discontinuation of the sodium nitroprusside infusion but returned to baseline at 8 and 12 min after discontinuing sodium nitroprusside. However, both dense and alpha-granule release to adenosine diphosphate after in vivo sodium nitroprusside were never significantly inhibited even at the time when sodium nitroprusside infusion was maximal. In contrast to our in vivo findings, in vitro incubation of platelet-rich plasma with sodium nitroprusside resulted in significant inhibition of dense and alpha-granule release to adenosine diphosphate. These in vitro inhibitory effects of sodium nitroprusside were reversed by pretreatment with epinephrine but not phenylephrine.ConclusionsIn normal volunteers, sodium nitroprusside inhibits platelet aggregation to epinephrine but not adenosine diphosphate; inhibition was reversed within 8-12 min after discontinuing sodium nitroprusside. Sodium nitroprusside in vitro inhibition of platelet function to adenosine diphosphate was reversed by epinephrine pretreatment. Because of the rapid reversibility of its antiplatelet effect, sodium nitroprusside may be clinically useful even when there is the potential for impaired coagulation.